• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• 제25권1호
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• pp.31-35
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• 2014

Objectives : The aim of this study was to evaluate the effectiveness and feasibility of coblation resection for the treatment of laryngotracheal disease. Methods : We conducted a retrospective review, evaluating 7 patients with laryngotracheal disease treated using coblator. Information collected included demographic data of the patients, diagnosis, size and location of the disease, procedure time, the number of previous operation, and the postoperative complication. Results : Among the etiology, granulation is most frequent (n=4), followed by recurrent repiratory papillomatosis (n=2) and tracheal stenosis (n=1). The location of lesions was peristomal area (n=2), glottis (n=2), subglottis (n=2) and mid-trachea. Coblation resection could remove the lesions completely and there was no significant complication including local burn, bleeding, and hypertrophic scar. The procedure time was shorter than the previous operation using $CO_2$ laser. Conclusion : Coblation resection is an effective and safe method for layngotracheal disease and can substitute the classic method such as $CO_2$ laser.

• Archives of Craniofacial Surgery
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• 제14권2호
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• pp.133-136
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• 2013

Retrobulbar hemorrhage is a rare but serious complication after blepharoplasty, mid-face injury, and treatment of facial bone fractures. The incidence of postoperative retrobulbar hemorrhage is 0.055% with an incidence of associated permanent blindness of 0.005%. A 69-year-old male came to the emergency room with pain on both orbital areas and uncontrolled bleeding after cosmetic lower blepharoplasty performed at a private clinic. He had not been evaluated preoperatively by the private clinic, but we found that he had undergone percutaneous transluminal coronary angioplasty and taken anticoagulants for 10 years. We performed an emergency operation to evacuate the hematoma. However, after surgery, he persistently complained of orbital pain, pressure and diminished visual acuity. Intraocular pressure was increased, and computed tomography demonstrated a retrobulbar hemorrhage with globe displacement. Emergent lateral canthotomy and cantholysis were performed. Intraocular pressure was decreased to 48/30 mm Hg immediately after the operation, falling within the normal range the next day. We recommend three points to minimize loss of vision by retrobulbar hematoma. Firstly, careful preoperative evaluation must be conducted including current medications, underlying diseases and previous history of surgeries. Secondly, cautious postoperative observation is important for the early diagnosis of retrobulbar hematoma. Lastly, immediate treatment is crucial to prevent permanent blindness.

• The Korean Journal of Pain
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• 제31권4호
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• pp.296-304
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• 2018

Epiduroscopy is defined as a percutaneous, minimally invasive endoscopic investigation of the epidural space. Periduroscopy is currently used mainly as a diagnostic tool to directly visualize epidural adhesions in patients with failed back surgery syndrome (FBSS), and as a therapeutic action in patients with low back pain by accurately administering drugs, releasing inflammation, washing the epidural space, and mechanically releasing the scars displayed. Considering epiduroscopy a minimally invasive technique should not lead to underestimating its potential complications. The purpose of this review is to summarize and explain the mechanisms of the side effects strictly related to the technique itself, leaving aside complications considered typical for any kind of extradural procedure (e.g. adverse reactions due to the administration of drugs or bleeding) and not fitting the usual concept of epiduroscopy for which the data on its real usefulness are still lacking. The most frequent complications and side effects of epiduroscopy can be summarized as non-persistent post-procedural low back and/or leg discomfort/pain, transient neurological symptoms (headache, hearing impairment, paresthesia), dural puncture with or without post dural puncture headache (PDPH), post-procedural visual impairment with retinal hemorrhage, encephalopathy resulting in rhabdomyolysis due to a dural tear, intradural cyst, as well as neurogenic bladder and seizures. We also report for first time, to our knowledge, a case of symptomatic pneumocephalus after epiduroscopy, and try to explain the reason for this event and the precautions to avoid this complication.

• Journal of Chest Surgery
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• 제20권2호
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• pp.281-288
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• 1987

A total and consecutive 163 patients underwent cardiac valve replacement using the Hancock porcine xenograft cardiac valves from 1 976 to 1984. Of 198 substitute valves, 177 were the Hancock valves. One hundred twenty-nine patients[79.1%] had single valve replacement: MVR 118, AVR 8 and TVR 3; 33[20.3%] had double valve replacement: MVR+AVR 27 and MVR+TVR 6; and a single case had triple valve replacement. Other surgical procedures were added in 34 patients. The operative mortality rate within 30 days of surgery was 6.1%, and it was, however, 4.2%, with single MVR. Late mortality rate was 6.7% or 1.95%/patient-year of a linealized mortality rate. Early survivors of 153 patients were followed up for a total of 565.1 patient-years [a mean of 44.3*27.1 months]. The linealized annual complication rates were: 1.95% emboli/patient-year, 0.89% bleeding/patient-year 1.24% endocarditis/patient-year, and 4.25% overall failure/patient-year. Primary tissue failure occurred at a rate of 1.59%/patient-year. The actuarial survival rates including operative mortality were 87.0*4.1% and 77.3*6.6% at 5 and 11 years after surgery respectively. The probability of freedom from thromboembolic complication of 89.2*3.4% at 5 years after surgery lasted unchanged upto 11 years. The probability of freedom from overall valve failure was 81.3*4.5% at postoperative 5 years, and it dropped down to 26.2*19.4% at 11 years, although the latter was statistically insignificant because of a small number of patients entering into the years approaching the follow-up end. However, the probability of freedom from the primary tissue failure was 81.3*10.6% at postoperative 9 years, which coincides closely with the speculated rate of tissue degeneration of about 20% in 10 years. These clinical results confirm the low thrombogenicity of the Hancock porcine valve and the reasonable failure rate of tissue degeneration.

• Journal of Periodontal and Implant Science
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• 제50권2호
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• pp.97-105
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• 2020

Purpose: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions: NDIs in the anterior and posterior jaws functioned equally well in terms of periimplant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

• Journal of Chest Surgery
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• 제41권4호
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• pp.516-519
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• 2008

Aorto-cutaneous fistula is a rare complication after performing open heart surgery, but if this develops, it is a fatal condition. So, prompt diagnosis and aggressive surgical treatment is needed. We report here on a patient who had two mechanical double valves placed during heart surgery and she was treated for repeated sternal wound infections for about 5 years. She visited the ER due to abrupt bleeding at the sternal wound. She was diagnosed as having an aorto-cutaneous fistula by performing an aortogram and we then performed cardio-pulmonary bypass surgery. The patient is currently doing well and is under follow up 24 months after the repair.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.136-143
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• 2009

Objective: Remote cerebellar hemorrhage (RCH) is one of the rare complications occurring after supratentorial surgery, and its pathomechanism is poorly understood. We report 10 cases of RCH from our institution and review 154 cases from a database in order to delineate incidence, common presentation, risk factors, and outcomes of this complication. In addition, the means of prevention are discussed. Methods: We reviewed the medical records of 10 patients who experienced RCH after undergoing supratentorial surgery at our institution between 2001 and 2008. A database search in Medline revealed 154 cases of RCH in the English literature. Characteristic features were analyzed and compared. Results: There were 10 cases of RCH among 3307 supratentorial surgery cases, indicating a 0.3% incidence. All patients had characteristic imaging features of RCH, namely a streaky bleeding pattern in the superior folia of the cerebellum. Seven patients had a history of preoperative hypertension. Four cases were related to cerebral aneurysms, and other four developed after the removal of brain tumors. Cerebrospinal fluid (CSF) drainage apparatuses were installed postoperatively in all cases. Outcomes according to modified Rankin scale (mRS) were good in 7 patients, with 1 fatal case. Conclusion: RCH is a rare complication after supratentorial surgery, and the exact etiology still remains uncertain. Hypertension and perioperative loss of CSF seem positively correlated with RCH, but no single risk factor is totally responsible. Patients with RCH should be closely observed to improve their prognosis.

• Journal of Chest Surgery
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• 제16권4호
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• pp.584-593
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• 1983

Esophageal reconstruction was performed in 344 patients with irreversible stricture of the esophagus resulting from caustic burns at National Medical Center from 1959 to 1982.There were 113 males and 231 females, and ranging from 2.5 to 58 years of age, and mean age was 26.5 years, and 25 cases were less than 10 years old. Caustic materials were 286 [83.2%] alkali and 50[14.5%] acid. The most frequent stricture site was upper thoracic esophagus as 56.7%, and the next was cervical as 31.4%, and lower, 11.9%. The stomach was involved in 10.8% totally, and hypopharyngeal stricture was also noticed in 3.2%, and in 3 cases, hypopharyngeal reconstruction was needed due to extensive scar change. In 329 of total 344 cases, colon interposition was performed without resection of the strictured esophagus except 4 cases which were complicated T-E fistula or perforation, and most of them, about 10-15 cm of terminal ileum with right half of the colon was used as the graft. The left colon with anti-peristalsis was used as graft only in 30 cases. The most common postoperative complication was anastomotic leak as 16.7% of total cases, and it was 12.5% from neck, 3.3% from ileocolostoma and 0.9% from cologastrostoma. Next common complication was neck stenosis [8.8%], aspiration pneumonia [6.4%], and graft necrosis [3.9%] in order. Overall operative mortality was 5.5% [14/329], and main causes of death were graft necrosis, sepsis due to anastomotic leak, gastric bleeding, and intestinal obstruction. Besides of colon interposition, according to shape or level of the stricture, plastic repair or segmental resection and direct anastomosis was done in 9, and 1 of them were complicated stenosis at the anastomotic site. In lower stricture, esophagogastrostomy was done in 10 cases, and 1 case expired due to hepatitis, and anastomotic stenosis was occurred in 2 cases at 1.5 months and 2.4 years later. During follow-up of 298 cases colon interposition from 6 months to 22 years, 82.6% was excellent, and 2.9% was complained of mild discomfort, and 4 cases were dead laterly, but 3 of them were not related to reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.137-141
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• 2011

The extraction of an impacted third molar tooth is associated with many complications during the procedure and postoperative care. These complications include bleeding, swelling, pain, infection, as well as root fracture, proximal tooth injury, alveolar bone fracture, lingual nerve and inferior alveolar nerve injury etc. With the exception of a fractured root dislocation in the submandibular space, no direct submandibular gland injury related to extraction surgery has been reported until now. A 40 year old man visited the department of oromaxillofacial surgery at Yeouido St. Mary's Hospital for an extraction of the right mandible third molar. A partial third molar impaction was diagnosed by a clinical and radiographic examination. A surgical tooth extraction was practiced including buccal cortical bone osteotomy. During socket curettage, an encapsulated cyst-like lesion and a verified $3{\times}3\;cm$ neoplasm in the apically lingual direction were found during process of dissection. A biopsy confirmed that the neoplasm involved the submandibular gland and nerve trunk. This unusual anatomical organ injury during the surgical tooth extraction procedure is reported as a new complication during impacted third molar extraction.

• Clinical and Experimental Reproductive Medicine
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• 제14권1호
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• pp.29-35
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• 1987

Alternative methods were used in the field of infertility as the latest means for the treatment of misconception. Artificial insemination, which has been commonly used already, IVF-ET and GIFT are also used as artificicial method for conception presently. Appling such methods to the patient, following three categories should be considered; first, there should be an understanding and an agreement from the patient, second, if possible, reduce the cost of hospital expense and relieve physical and emotional problems of the patient, and third, increcrsing the pregnancy rate. Under these considerations, complication and pitfalls of artifical inseminations are a big burden to the physian and the patient. Though the conicicental complications are relatively very rare, detailed laboratoy tests, carefull examinations, and follow-up studies are necessary. In the distribution of the age groups, 40.3% was in the 25 to 29 years group, 30 to 34 years was 45%. 35 to 39 years was 8% and only 3.2% was above the 40 age groups. The range of infertile periods were from 1 to 17 years, and half of the patients were over 5 years, the other group 20% in 3 years and 2 to 4 years were 10%. Among 159 cycles of artificial insemination, there were complications such as infection(1.9%) and discomfort(5%) and abnormal bleeding (0.6%). During pregnancy, clinical abortion (1.9%) and toxemia (2.5%) were shown. Sex of new born infants were, male (68%) and female (31%). Fortunately, there were no cases of psychological complication and genetic abnormality. Indications of artificial insemination for male factors were aspermia (2.5%), azoospermia (28.8%), oligospermia (26.4%) and asthenozoospermia (1.8%), for female factors were irregular cycle (11.7%) and dysmucorrhea.